Barbara Smith, RN, Mount Sinai Health Sysytems and Bryan Christiansen MD,(monitor-R) CDC Infection Control Team for the Ebola Response demonstrate the proper technique for donning protective gear during an ebola educational session for healthcare workers at the Jacob Javits Center in New York on October 21, 2014. (Timothy A. Clary/AFP PHOTO)

Thousands of Nurses Learn New Ebola Procedures

NEW YORK—Thousands of doctors and nurses attended an education session on Ebola in Manhattan Tuesday, where officials from the Centers for Disease Control and Prevention (CDC) demonstrated how to safely treat patients if New York City were to suffer an outbreak of the virus.

Billed as a training session for health care workers, the event also served the dual purpose of shoring up public morale about the city’s readiness to combat the virus.

“As great as the problem of the disease, we have a second problem that may even be more difficult than dealing with the disease, and the second problem is dealing with people’s anxiety and people’s panic,” Gov. Andrew Cuomo told the crowd at the Javits Convention Center.

More than 88 potential Ebola patients were reported by New York City physicians in early October; among them, nine suffered from malaria instead.

Cuomo reversed his position on flight bans on Monday, saying that the federal government “should seriously consider” banning flights from the Ebola-stricken nations of Guinea, Liberia, and Sierra Leone in West Africa.

The governor had previously dismissed flight-ban proposals from his Republican challenger Rob Astorino, saying that they could easily be bypassed.

Speaking after the governor, Mayor Bill de Blasio assured the audience that “every hospital in the city is ready” to combat the Ebola virus, especially Bellevue Hospital Center, which has spearheaded preparations and could handle “whatever situation” that might arise.

Crisis of Confidence

Public confidence in the ability of U.S. health providers to contain the spread of Ebola suffered a blow after two nurses at a hospital in Dallas contracted the virus while treating Thomas Eric Duncan, who flew into Texas from Liberia and died from the disease on Oct. 8.

The Texas Health Presbyterian Hospital has maintained that its nurses were following protocol from the CDC while treating Duncan.

“We have remained committed to complying with CDC guidelines from the start. We believe our procedures complied with the CDC Ebola guidelines and our staff implemented them diligently,” Texas Health said in a statement last week.

On Monday the CDC issued new voluntary guidelines for health workers treating Ebola, recommending the use of face shields, hoods, boot covers, and other garb that doesn’t leave any part of the body exposed.

Briana Aguirre, a nurse at Texas Health, claims that the nurses treating Duncan were using hospital gear that exposed their necks.

“We may never know exactly how that happened, but the bottom line is, the [old] guidelines didn’t work for that hospital,” said Tom Friedan, director of the CDC.

Improved Protocols

“We are here because one health care worker getting Ebola while caring for a patient is too many,” the CDC’s Arjun Srinivasan said to an applauding crowd.

At the session, Srinivasan walked through the basics of the Ebola virus—the potential scope of the epidemic, symptoms of infected patients, and how the disease is transmitted—then explained the merits of the new CDC guidelines.

“This new guidance reflects a tremendous amount of new information we have from taking care of the first patients with Ebola who have been cared for in hospitals in this country,” he said. “The new guidance is designed to allow for the biggest margin of safety in caring for these patients.”

The new guidelines were drawn from lessons learned by health care workers in Doctors Without Borders, Emory University, and the Nebraska Medical Center, where a freelance American journalist who contracted the virus in Liberia is undergoing treatment.

The biggest changes in the new guidelines concerned the use of protective hoods to cover all skin surfaces, sanitation for gloves after treating a patient, and air respirators to prevent infection from aerosol particles, although the CDC maintains that Ebola is not an airborne disease.

Despite the new protocols, Srinivasan said that hospitals should limit the number of workers treating Ebola patients to an “absolute minimum” needed to provide adequate care.

A member of the CDC’s Ebola Response Team and a nurse from Mount Sinai Health System then demonstrated how to properly put on and take off the protective gear in line with the new procedure.

The new procedure, which took 20 minutes in the demo, requires two people—one trained observer to make sure that the protective equipment is put on properly.

“Practice, practice, practice,” nurse Barbara Smith said after the demo. “Even just removing the gloves, which you’ve done that hundreds of times in a week, don’t rely on what your past knowledge is, have someone vet that you really know each step of the way.”

More than 8,500 have been infected by Ebola thus far, according to the World Health Organization, and more than half of those infected have died from the disease.

Srinivasan warns that the death toll could rise to more than half a million in early 2015.

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